Joel lived in a luxury high-rise apartment building. His salary wasn’t really high enough to afford it, but he lived cheaply otherwise, so he decided to splurge on his living accommodations. Joel liked the building, but he hated the long elevator ride up to his apartment. Elevators were one indignity that Joel had to constantly endure thanks to his wheelchair. Before he was injured, he thought nothing of sprinting up seven or eight flights of stairs.
He grabbed the mail when he got home and caught the elevator just as the door was closing. A married couple held the door for him as he backed in. As he stretched to press the button for his floor, the woman quickly said, “I’ll get it for you. What floor do you want?”
“Twenty-six, thanks,” Joel said.
The woman flashed him a broad, condescending smile. His first instinct was to feel annoyed at her, as she leaned against her tall husband’s shoulder. Even though he was 34, the idea of marriage seemed very far out of his reach.
When Joel reached his apartment and began shuffling through his mail, he found the newest edition of Best Doctors in America. It was a magazine that was sent out in the mail each year and went through every field, naming the top doctors. Joel knew he’d never be included in the book—he didn’t have the dedication to be that great an internist.
For his own amusement, he flipped to the section on surgeons. He knew this was a dangerous game—he was likely to see the name of at least one of the residents he had worked with or an old classmate and feel a bout of jealousy that would plague him for days. Yet he couldn’t stop himself.
This time, however, he saw a name in the book he hadn’t seen before: Kyra Manning.
Seeing the name of the woman he had almost married on that list made him want to hurl the book out the window. He had been ten times the surgeon she was, but now she was the one who was making a name for herself as a surgeon. It wasn’t fucking fair.
Their relationship was destined to fail from the second Joel’s car smashed into that divider. Kyra tried her best to stay positive, but he could tell that all her romantic feelings for him had cooled. She didn’t respect him anymore and he was certain that his new body disgusted her. Eventually, Joel found himself starting to resent her. Then he started to hate her. That’s when he knew it was time to leave.
It was one of the first times Kyra had seen him in a wheelchair and one of the first few times he had ever been in the damn thing. He wore that thick brace on his chest and the parts of his back he could still feel hurt like hell. His sweatpants were hiked up to reveal the support stockings on his calves and he was sure the padding under his ass showed through the pants. He was trying to wheel the chair on his own, but he was having trouble getting a good grip on the wheels with just the palms of his hands. He felt completely crippled and helpless.
Wow, Kyra had said enthusiastically, you look really good, Joel!
He had stared up at her, still wearing her scrubs, a slight indentation across her cheeks from the mask she had been wearing during a recent surgery. He despised her for her daily condescending remarks. I look good? I look good??? I’m a fucking quadriplegic, Kyra. He made the decision right then and there: he didn’t want to stay with someone who was only with him because she felt sorry for him. Please don’t come here anymore, Kyra. Okay?
He had almost been hoping she’d fight with him a little bit, but she didn’t. She respected his wishes and she left. He later heard through the grapevine that she was marrying another resident in the program. It figured—surgery was too big a part of Kyra’s life for her to look elsewhere.
Joel checked the messages on his machine and it was the usual garbage. His mother’s concerned voice: “Joel, it’s your mother. Are you eating okay? Call me back, honey.” Followed by a telemarketer, then a message from his dentist, reminding him he had a cleaning scheduled in two days.
While the messages were playing, Joel wheeled himself to the bathroom, to catheterize his bladder. The schedule he found worked best for him was to do it every four hours. He had discovered that he usually couldn’t make it through the night, so he generally inserted an indwelling catheter with a legbag at bedtime. He didn’t like the indwelling catheters, but he found that the condom catheters were hard to put on often came off on their own during the night, leaving him with wet sheets to change.
Joel had a small amount of sensation in his penis, in that he could feel it when he got an erection, although he felt it more as a tingling in the upper part of his body. He got erections occasionally when he manipulated his penis, such as when catheterizing or washing it, never from his thoughts. He masturbated very rarely these days—it usually took a long time to ejaculate if he came at all and he just didn’t have the same drive that he used to. It was his worst nightmare to have a sexual encounter with a woman and not be able to get it up for her. He supposed in a way, he was lucky the situation hadn’t come up yet.
As Joel adeptly inserted the catheter into his bladder and watched the urine flow out, as was his routine for the last six years, he let out a sigh. This wasn’t how he had pictured his life at age 34. He had thought he’d be a great surgeon by now, not some incontinent, wheelchair-bound internist.
Joel knew things could have been much worse. He saw guys in rehab who were high quads, dependent on ventilators, dependent on someone else just to feed and dress them. That could have easily have happened to him—if his injury had been only slightly higher up, he would have at the very least required an aid in his daily life. It was hard to feel sorry for himself when he was around people like that. But out in the real world, he recognized that most people weren’t disabled. Most doctors didn’t have to use hat tricks just to inject a few cc’s of lidocaine. He was, in fact, the only disabled attending that the hospital had ever hired.
It was one thing to live a mediocre life. It was something very different to have the world in the palm of your hand and then throw it all away.
---------------------------------------------------------------------------------
Ann came home that night more excited than she had ever been before in her life. She felt like this was the first time someone had believed in her since she had been accepted into medical school. She didn’t quite understand what potential Dr. Dergan saw in her, but she was determined not to let him down.
Ann changed out of her work clothes into pajamas and went to the kitchen to cook pasta for dinner. As she stirred the noodles in the boiling water, she hummed to herself. She had already decided she was going to study while she ate.
“What are you so happy about?” Ann’s roommate Lori asked. Lori dropped her keys on the dining room table and shrugged off her own short white coat. Lori was on a pediatric clerkship right now and she looked completely spent. There was a smiley face sticker plastered on the front of her shirt that was a stark contrast to her own expression.
“My attending is really awesome,” Ann replied.
“Who’s that?” Lori asked. She leaned against the refrigerator as she tugged off her three-inch heels.
“Dr. Dergan,” Ann said.
Lori must have heard the name before because she started laughing. “You’re joking, right? He’s a nightmare.”
“How do you know him?”
“Last year I signed up for that program to shadow a doctor and they stuck me with him,” Lori explained. “One day of following Rollerdoc around the hospital and I quit the program.” She shook her head. “He tries to act like he wants to teach you, but really, he’s just a mean, bitter asshole.”
“I think you’re wrong,” Ann said.
Lori raised a finely plucked eyebrow. “Whatever you say, Annie. What did he do that made you want to hum in your PJs?”
“He offered to help me get into a surgery residency,” Ann said. “Just out of nowhere.”
“Really?” Lori looked Ann up and down. “Just out of nowhere, huh?”
“What’s that supposed to mean?”
“You think he has no ulterior motives for doing that?” Lori said. “You think after hating every single med student, he just suddenly took a random interest in his cute young third year med student?”
“Hey, you’re a lot cuter than I am. If he was going to hit on one of us, I’m sure he would have picked you.”
“Maybe he likes brunettes,” Lori suggested. “All I’m saying is it just seems a tad suspicious to me. You really don’t think he expects something from you?”
“He likes me because I want to be a surgeon,” Ann said, although the conviction in her voice was wavering.
“I’m sure he does,” Lori said.
Ann lay down the spoon she had been stirring her pasta with and crossed her arms. “Look, he’s got a spinal cord injury. He probably can’t even…”
“Men are really resourceful,” Lori said. “I’m sure he’s got some way of doing it.”
Ann had never considered that Dr. Dergan wanted to advise her because of some sexual interest in her. Yet now that Lori was saying it, it made a lot more sense than that whole story about how he thought she had potential.
Even though she hated the thought of him only wanting to advise her because of some kind of attraction, she was also strangely intrigued by the idea. Even though she never would have confessed it to Lori, Dr. Dergan was undeniably sexy. He was so smart and confident… and she loved the way that he used his hands, despite his problems with his fingers. When he had held her wrist today, she felt the warmth of his grip and was drawn to him.
But as she drained the pasta into the sink, she realized how silly she was being. Whatever Lori believed, Dr. Dergan was a professional and not the sort of person who would ever get involved with a student. Maybe he felt sorry for her—she wasn’t sure. But either way, she couldn’t fathom that his intentions were even close to what Lori had suggested. The man didn’t even date, apparently; either he was holding out for someone perfect (and Ann certainly was not perfect) or he wasn’t interested in a relationship. Either way, the thought of him wanting Ann was… well, preposterous.
---------------------------------------------------------------------------------------
At the end of Ann’s first week, Raj, the senior resident on her team, asked her if she was interested in doing an “admission” with him. That would involve going down to the emergency room to see a new patient, get a fresh history and physical, and write admission orders. “Do you think I’m ready for that?” Ann asked him.
Raj shrugged. “Gotta do it sometime.”
Those weren’t exactly words of confidence, but Ann figured he was right. She wanted to know what it was like to do an admission on her own and this was the only way to learn. Anyway, it was better to do it now, while Raj was looking over her shoulder to keep her from making any serious mistakes.
The ER was down on the first level of the hospital. The entire area smelled vaguely of antiseptic and something else she couldn’t identify. The second she walked in, a man was whisked by her on a stretcher, wearing a collar around her neck. Ann jumped out of the way just in time to avoid getting smacked into as Raj strode forward confidently. She stood with her back pressed against the wall as a team of paramedics pushed past her in pursuit of the stretcher.
Raj turned around and gave her a funny look. “Ann, come on!”
She suppressed an urge to grab onto his arm for support as she followed him down the hallway, dodging nurses as she walked. She kept her arms folded across her chest, clutching her notebook, trying to make herself as small as possible. She nearly tripped over a crash cart sitting in the hallway and Raj flashed her an irritated look.
The patient’s name was Morton Baker. Before Ann even walked into the room, she could smell the alcohol in the air. Alcohol and urine. Baker’s eyes were bloodshot and his thin lips were curled into a snarl. He wore a floral-printed hospital gown covering a belly that could have easily carried triplets. He eyed Raj and Ann suspiciously as they entered the room. “What? More blood? I don’t got anymore blood.”
“Mr. Baker, I’m Dr. Mohindra from the medicine service,” Raj said. “You’re going to be admitted and brought upstairs.”
“Fine, whatever you say, doc,” Baker growled. “Not like I can stop you.”
Despite Mr. Baker’s belligerent tone, Raj went on: “This is Ann, one of our medical students. She’d like to ask you a few questions.”
Raj gestured for her to step forward and start questioning the patient. Ann didn’t want to get any closer to Mr. Baker than she already was, if only because of the smell. Her stomach filled with butterflies as Raj backed out of the room, leaving her alone. Ann cleared her throat and took out a pen, “So um, Mr. Baker, what brought you to the hospital today?”
“What do you think? The bus.”
“No, I mean… what um… medical problem did you come for?”
Mr. Baker opened his mouth, revealing teeth that were yellowed and largely missing. “Well, my belly’s been hurting me the last week and getting big. And my testicles are getting big too. Want to see?”
Ann’s face turned red. “I’ll examine you later, Mr. Baker.”
She heard a familiar voice outside the room and she quickly excused herself. She stepped out of the room and saw Dr. Dergan sitting in his wheelchair, talking to Raj. “You really don’t need to stay here, Dr. Dergan,” Raj was saying. “It’s getting late and I don’t know how soon we’ll be finished.” He gestured in Ann’s direction by way of explanation.
“I don’t mind,” Dr. Dergan said. “If you present the patient now, we’ll save time tomorrow morning.” He set his light brown eyes on Ann’s face. “Are you almost done with him?”
“Not really,” Ann admitted.
Dr. Dergan lifted an eyebrow. “Well, what can you tell me so far?”
“He’s got… abdominal pain and swelling,” Ann said. “That’s… all.”
Dr. Dergan and Raj exchanged looks. “You want me to go in there with you?” Dr. Dergan asked.
Before Ann could answer, Raj started shaking his head, “You don’t have to do that, Dr. Dergan. Really.”
“I need to see Ann do a patient interview at some point,” Dr. Dergan argued. “After all, I have to give her a grade.”
Ann felt uneasy at the idea of Dr. Dergan determining a grade for her. But as much as she hated to admit it, she wanted him to come in with her to see the patient. She was frightened of Mr. Baker, and her attending’s presence would be a comfort.
“It’s okay with me,” she agreed.
Dr. Dergan followed her into the patient’s room. She held the door open for him to push his chair through. He didn’t smile when he addressed Mr. Baker: “I’m Dr. Dergan, the medicine attending. I’m going to stay in the room while Ann asks you questions.”
Baker looked him over, taking in the wheelchair and Dr. Dergan’s motionless legs. “You’re a doctor?”
“Yes.”
“Where’s your white coat?”
“I don’t wear a white coat.” Dr. Dergan’s replies were calm, almost rehearsed, which made Ann wonder how many times he had been asked these questions. He pointed to the stethoscope around his neck. “I’ve got a stethoscope. Does that help?”
Baker shrugged. “All right, what’s her questions?”
Dr. Dergan nodded at Ann and she started back in with her questions. Although she felt comforted by his presence, it also made her feel anxious in a different way. She felt like he was judging her. She was worried that she was asking the wrong questions and he was thinking what an airhead she was. She kept glancing over at him for signs of approval, but his face was impassive. He was leaning forward in his wheelchair, his eyes staring past Mr. Baker at the wall.
“How much alcohol do you drink?” Ann asked. It was a standard question to ask every patient, but especially important in a patient who smelled of alcohol and clearly had liver cirrhosis.
“What are you talkin’ about?” Baker said.
“Like in an average day,” Ann clarified, “how much do you drink?”
“You got some nerve asking me that,” Baker growled. “That ain’t none of your business. I ain’t some lousy drunk. Who the fuck do you think you are?” As he spoke, he rose from the bed and took a menacing step in Ann’s direction, his hand balling into a fist. She clutched her notebook to her chest.
Before Baker could move any further, Dr. Dergan spun the wheels on his chair and intercepted him, lodging his wheelchair in the patient’s path. He didn’t touch Baker, but gave him a hard look. “Sit down, Mr. Baker.”
The patient hesitated for a minute and Ann didn’t take her eyes off his fist. Oh my god, he’s going to hit Dr. Dergan in the face! But instead, his fist loosened and he sat down on the bed. “Sorry,” he mumbled.
Even sitting on the bed, Baker’s was above eye-level with Dr. Dergan, so that the attending had to look up to address him. “Now tell me,” Dr. Dergan said, “when was your last drink?”
“This morning,” Baker admitted, his shoulders sagging.
Dr. Dergan finished off the interview as Ann watched. She couldn’t help but by impressed with his style and wondered if she’d ever be half the doctor he was. Certainly she’d never be as great a surgeon as he used to be. She watched him examine Baker’s abdomen with such skill, she never would have known that he was unable to use his fingers. He really hid it well.
After he finished the history and they did a physical exam together, Ann followed Dr. Dergan out of the room. She still had sweat stains under her armpits thanks to what had happened, but he looked completely calm and collected. “Sorry,” she said.
He waved his hand at her. “It’s not your fault.” He shrugged. “Most patients aren’t going to hit a guy in a wheelchair, so I feel pretty safe. The lesson here is if a patient becomes aggressive, sometimes it helps to be… you know, sitting down. It makes them feel less threatened. Of course, I’ve got the advantage in that I’m always sitting, but I think it helps.” He shrugged. “Course, I never ever used to sit down before I had to.”
Ann nodded. “Have you ever been attacked?”
Dr. Dergan laughed. “Yeah, I have. Way back when I was a medical student, taking my psych rotation. A schizophrenic patient jumped me while I was examining him in the ER.”
“Oh my god! What happened?”
“Well, believe it or not, I was in pretty decent shape back then,” he said. “So I managed to fend him off until security got into the room. I did get a black eye though.”
You’re still in pretty decent shape, Ann wanted to say. She loved seeing the hints of muscle through his shirt, although his legs were bone thin. She wasn’t sure how he’d take that kind of compliment and she didn’t want to find out.
Dr. Dergan looked at his watch. “That was a little more time than I wanted to spend. I’ll let you off the hook for now, but Ann, tomorrow I want a full presentation on the management of alcoholic cirrhosis.”
She nodded. “Yes, sir.”